Individual provider Active NPI

Jared Landry, M.D.

  • Anesthesiology Physician
  • Thibodaux, LA
National Provider Identifier
1295059202
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD.206604 Issued in LA
Practice address
602 N Acadia Rd
Anesthesia Dept.
Thibodaux, LA 70301-4847
Phone
(985) 438-1188
NPI assigned
Mar 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.206604 LA Primary

Addresses

Primary practice location

602 N Acadia Rd
Anesthesia Dept.
Thibodaux, LA 70301-4847

Mailing address

119 W Lakeshore Dr
Thibodaux, LA 70301-1607
Phone (337) 802-2639

Other identifiers 2

IdentifierTypeStateIssuer
300093737OtherLARAILROAD MEDICARE PTAN
2106961MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028002597 LA Practitioner - Anesthesiology 4587885967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians
Thibodaux Regional Network Development CorporationGroup PAC ID 8224011754, 138 clinicians
Zephyr Anesthesia LLCGroup PAC ID 1658559125, 161 clinicians

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2000

602 N Acadia Rd
Hospitalists Dept
Thibodaux, LA 70301-4847
Phone (985) 493-4544

604 N Acadia Rd
Suite 300
Thibodaux, LA 70301-4897
Phone (985) 449-1244

Hospital & facility affiliations

  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
67.62
Promoting interoperability
100
Improvement activities
40
Cost
71.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC CurrentSince Dec 30, 2016 Accepting new patients
Zephyr Anesthesia, LLC Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Aug 30, 2014 Accepting new patients
Thibodaux Regional Network Development Corporation Anesthesiology Current Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Aug 30, 2014 Accepting new patients

Locations

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

5150 Robotics Ln
Lake Charles, LA 70605
Phone (337) 214-1591

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

604 N Acadia Rd
Ste 300
Thibodaux, LA 70301
Phone (985) 438-1088

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1295059202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W LAKESHORE DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703011607",
            "telephone_number": "337-802-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "address_2": "ANESTHESIA DEPT.",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014847",
            "telephone_number": "985-438-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JARED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.206604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "300093737",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106961",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.